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CDM 4 Exam 1 > Lecture 4 - Contraception > Flashcards

Lecture 4 - Contraception Flashcards

1
Q

Sponge info

A

1 time use

insert 24hrs before, leave in for at least 6, no more than 30 hrs

OTC

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2
Q

Diaphragm info

A

plastic, reusable and lasts 2 yrs

have to fit it with provider and use w/ spermicide

its RX

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3
Q

Cervical Cap info

A

used up to 2 yrs

used combo w/ spermicide

its RX

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4
Q

Conditions when estrogen is not preferred?

A

Migraine headaches
> 35yrs old and smoker/obese
History of thromboembolic disease
Cardiac disease, CAD or HF
Cerebrovascular Disease
Hypertriglyceridemia
HTN + vascular disease or > 35yr old

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5
Q

What does Phasic Mean

A

Mono = same estrogen/progestin each pill
Bi = same estrogen, progestin inc about half way
Tri = hormones change every 7 days

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6
Q

Conventional vs extended cycle

A

21 active + 7 inactive

or can do active nonstop or 84days active/ 7 inactive

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7
Q

Estrogen Dosing & SE

A

30mcg = normal

higher doses = more SE, forgiving dosing, less bleeding
Lower = less SE, less forgiving dosing, more bleedings

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8
Q

Progesterone Dosing & SE

A

Earlier gen = more androgenic (less clotting and more SE)

Later Gen = more estrogenic (less term SE, more Estrogenic SE)

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9
Q

Counseling points for Birth control

A

same time every day
at night w/ food if N/V occurs
Managing missed pills
When to start

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10
Q

Starting methods

A

Quick = start use back up for 7 days
Sunday = start 1st Sunday after menses and backup for 7 days
1st day start = start on day 1 menses, no backup needed

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11
Q

Managing Early breakthrough bleedings

A

days 1-9

switch to higher estrogen or switch to multiphase pill with higher estrogen in beginning of cycle

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12
Q

Managing late breakthrough bleeding

A

days 10-21

Switch to higher progestin or switch to multi phasic pill w/ high progestin dose at end of cycle

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13
Q

DI w/ Birthcontrol

A

Anticonvulsants
NNRTIs
Protease inhib
ABX = rifampin

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14
Q

How to counsel if late/miss pill

A

< 24hrs = take as soon as possible and continue rest usual time

if miss > 2 pills, start on back up contraception

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15
Q

Progestin only pills

A

“mini pills”

used for pts on inc clot risk
migraines
lactating women

Has to be taken same time each day

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16
Q

Progestin only pills, what to do if miss

A

< 3 hrs, take asap
> 3 hours, use backup for 2 days

Drosperinone = improved missed dose time

17
Q

IUD Menses SE Cooper vs LNG

A

Copper = longer and heaver menses, more crampign

LNG = spotting in 1st 6 months, amenorrhea

copper preferred in pts who dont want hormones used

18
Q

IUD SE

A

Common = ab pain, Fatigue, HA, Dizziness, breast tender, nausea

Rare = Expulsion of IUD, perforation cervix/uterus, infections

19
Q

Implant Birthcontrol

A

Nexplanon
Good for 3yrs (5 yrs off-label)

SE = irregular bleeding, mood change and weight gain

put in by provider

20
Q

Injectable Birthcontrol

A

DepoProvera
done every 3 months
Given IM or SubQ

SE = irregular bleeding, weight gain, osteoporosis risk = take with Vit D/calcium

back up 1st 7 days after 1st, or if more than > 15 weeks since injection (so miss 3 month mark)

21
Q

Transdermal Patch Birthcontrol

A

Xulane, Twirla

1 patch QW for 3 weeks, then 1 patch free week

Decreased efficacy if BMI > 30

Safety = inc exposure to estrogen

22
Q

Vaginal Ring Birthcontrol

A

Nuvaring = brand = every 3 weeks
EluRyng = generic
Annovera = can be reused for 1 year

Less N/V than other options

Safety = Amy inc vag secretions and irritation

23
Q

When is progestin only products or Copper IUD recommended

A

> 35yrs old +

BMI > 30
DM
Uncontrolled HTN
Smoker
Migraines
Immobile

24
Q

if pt experience Aura with Migraines then they are….

A

at inc risk go stroke = Progestin ONLY

if no aura = estrogen OK

25
Q

Emergency Contraception eligibility criteria

A

child-bearing age who experienced these events in last 120hrs….

unprotected sex
contraceptive failure
sexual assault

repeated use of EC doesn’t make someone ineligible

26
Q

LNG emergency contraceptives how it works

A

used to prevent fertilization and implantation

effectiveness wanes over time**

most effective up to 72hrs

27
Q

LNG emergency contraceptives info

A

OTC

efficacy dec those who weight > 165lbs or BMI > 25

given as one dose ASAP

28
Q

Ella MOA & info

A

inhibit/delay ovulation

** Effectiveness doesn’t decrease over time**

Selective progesterone receptor modulator

take within 5 days, and can use BMI > 25, but efficacy decreases > 35

29
Q

Emergency Contraceptives IUD

A

Paragard = copper IUD

has to be inserted 5 days after sex and 99% effective

30
Q

Counseling for EC

A

if vomit within 2-3 hrs, repeat dose
Won’t protect against HIV/STI
If menses > 1 week late…take a preg test
Take the drugs ASAP, pref within 72hrs

31
Q

Obese pts special info

A

Progestin only if BMI > 25

Ella (Ulipristal Acetate) can be used BMI 25 -35

Copper IUD if > 35 BMI

CDM 4 Exam 1 (12 decks)

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